Expert review of vaccinesJul 31, 2018

Using vaccines and immune checkpoint blockers together to boost and improve cancer immunotherapy

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 4, 2026

Abstract

Most combination trials of vaccines and immune checkpoint inhibitors (ICIs) are in early phases, with several now in phase III.

Therapeutic cancer vaccines, such as sipuleucel-T and talimogene laherparepvec, have been approved for specific cancers.
Combining vaccines with ICIs may improve response rates and the durability of responses in cancer treatment.
Vaccines can potentially turn 'cold' tumors into 'hot' tumors, enhancing immune responses.
Neoantigens, which are specific to tumor cells, may lead to strong antitumor immune responses.
Techniques for identifying which neoepitopes to target based on tumor mutations are under development.
Successful combination therapies must enhance immune system priming, response expansion, and function within the tumor microenvironment.

Simplified

INTRODUCTION: Multiple immune checkpoint inhibitors (ICIs) that modulate immune cells in the periphery and the tumor microenvironment (TME) have been approved, as have the therapeutic cancer vaccines sipuleucel-T for metastatic castration-resistant prostate cancer and talimogene laherparepvec (T-VEC) for metastatic melanoma. These developments provide rationale for combining these modalities to improve response rates and durability of responses in a variety of cancers. Preclinical data have shown that vaccines can induce immune responses that turn a tumor from 'cold' to 'hot,' but vaccines do not appear to be highly active as monotherapy.

AREAS COVERED: Here, we provide a review of the current state of vaccine and ICI combination studies.

EXPERT COMMENTARY: Most combination trials are in early phases, but several are now in phase III. Vaccines that target antigens expressed exclusively on tumor cells, neoantigens, have the potential to induce robust antitumor responses. Several techniques for predicting which neoepitopes to target, based on tumor mutational profiling, are in various stages of development. To be successful, combination immunotherapy approaches must seek to prime the immune system, expand the immune response, and facilitate immune function within the TME.

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Declaration of interest. The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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Using vaccines and immune checkpoint blockers together to boost and improve cancer immunotherapy

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